random 3 Flashcards

1
Q

how frequently do you monitor vitals for peds sedation?

A

q10m

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2
Q

first step to CPR after drowning

A

2 rescue breaths

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3
Q

dose of IM succs to break spasm

A

4mg/kg

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4
Q

brown-sequard syndrome

A

ipsilateral loss of motor/proprioception at level of injury and contralateral loss of pain/temp 2 levels below

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5
Q

what’s the only type of shock where PCWP (preload) is increased

A

cardiogenic (backup of fluid)

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6
Q

what’s the only type of shock where SVR (afterload) is decreased?

A

distributive

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7
Q

what’s IM dose of epi in anaphylaxis

A

0.3-0.5mg q5-15m

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8
Q

risk factors for nerve injury during spine surgery

A

obese, male, malnutrition, long hospital stay

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9
Q

where are vasopressin and oxytocin synthesized?

A

hypothalamus - supraoptic and paraventricular neurons

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10
Q

neuromonitoring during aortic surgeries

A

tibial nerve most common. volatile suppresses motor more than sensory but motor is more specific. argument against monitoring is wont change clinical course (cant unclamp aorta)

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11
Q

contraindications to extracorporeal shock wave lithotripsy

A

pregnancy, active UTI, coagulopathy

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12
Q

peds epiglottitis considerations

A

under deep anesthesia (dont agitate), gas induction sitting up with monitors, IV, no paralytic, lie down, ETT one size smaller, keep tube in 48-72 hours (decrease swelling, air leak).

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13
Q

what’s electrode called that measures oxygen concentration in ABG mchines

A

clark

sanz - serum pH
severinghaus - co2
enzymatic - glucose

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14
Q

when do you need dental ppx

A

prostetic valve, valvulopathy after transplant, unrepaired CHD,

dental with manipulation, GI/GU with ongoing infection, infected skin biopsy, respiratory with incision or biopsy

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15
Q

immediate treatment of MVR from chordae tendinae rupture

A

nitroprusside (arterial vasodilator)

more likely to happen after inferior MI than anterior (perfusion to chordae)

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16
Q

treatment of acute MVR

A

full, fast, forward

17
Q

what results in the BIGGEST secretion of vasopressin?

A

hypotension (decreased stretch at carotid receptor bodies) and then hyperosmolality (sensed by hypothalamus)

18
Q

first response to NMBA

A

central (diaphragm, laryngeal) because greater blood flow

BUT diaphragm recovers faster as not as high density of nicotinic ACh receptors

recovery from fastest to slowest
diaphragm
laryngeal
corrugator supercili
abdominal muscles
orbicularis oculi
geniohyoid
adductor pollicis

19
Q

goals during CPB

A

CO 1.6-3L
arterial MAPS 50-90
venous O2 >65%

20
Q

first line treatment for TNS

A

NSAIDs

21
Q

isoflorane has coronary vasodilating properties

A

cool!

22
Q

acetazolamide does what and causes what

A

carbonic anhydrase inhibitor works at proximal tubule to prevent reabsorption of bicarb.
decreases pH (via loss of bicarb), compensatory decrease in CO2

indicated if edema AND metabolic alkalosis

23
Q

what directly stimulates aldosterone?

A

AT2

(also hypotension, hypoNa, HyperK, hypovolemia)

aldosterone works to increase Na retention

24
Q

pupillary light reflex?

A

afferent 2, efferent 3

25
Q

gag reflex

A

9, 10

26
Q

corneal reflex

A

5, 7

27
Q

carcinoid triad

A

diarrhea, flushing, cardiac involvement (tricuspid regurg)

28
Q

alveolar gas equation

A

PAO2 = ((Patm - Ph20) * FiO2 - (PCO2/R)

29
Q

acute and chronic bicarb changes in respiratory acidosis

A

acute: increase 2 bicarb for every 10 CO2
chronic: increase 4 bicarb for every 10 CO2

(assume normal bicarb 24)

30
Q

myotonia occurs in response to

A

stress, cold (warm fluids), pain, electrolyte imbalance
ion channel conduction issue
NDMB aint gonna help (issue is WITHIN motor unit rather than at endplate) and succs can precipitate a hyperK response and cause rigidity

31
Q

what to do in guillain barre?

A

absolutely avoid succs - prolonged paralysis, catastrophic hyperK response